NHS “wasting” millions prescribing gluten-free products

Megan White

The NHS spending millions of pounds prescribing gluten-free food products to coeliac sufferers is “a scandal”, according to family doctors.

Gluten-free food prescriptions cost the NHS £25.7million last year, and around 40 per cent of clinical commissioning groups in England have made cuts to save cash.

It’s ludicrous for the NHS to be treating a food product as a drug and to require GPs and pharmacists to behave as grocers

But, in a BMJ article this week, GP Doctor James Cave said: “It’s ludicrous for the NHS to be treating a food product as a drug and to require GPs and pharmacists to behave as grocers.”

Currently, the NHS pays up to £6.73 for 500g of pasta, yet 500g of gluten free pasta will cost just £1.20 at a supermarket.

And there is a dispensing fee which is charged on top of all prescriptions.

Dr Cave says the “complex rules” imposed by the NHS governing what can be prescribed and how often are stressful for people with coeliac disease and their GPs.

He said: “It’s a time-consuming rigmarole and, for the NHS, a very expensive one.

“The eight basic gluten-free staples advised for people with coeliac disease are all cheaper from a supermarket than the NHS price.

“This is a scandal.

“If we stopped prescribing gluten-free products tomorrow GPs would shout for joy and the NHS would stop being ripped off.”

Dr Cave suggests introducing a national voucher scheme or a personalised health budget for patients, so they receive the difference between the cost of gluten free products and the prescription.

He added: “This could be funded from the money saved by no longer paying for overpriced NHS gluten-free food.

“The price of gluten-free food might fall further once proper market forces were in play.”

“Most importantly, people with coeliac disease who currently struggle with the logistics of a lifelong gluten-free diet and a cumbersome and antiquated supply system, would have the convenience and choice we all enjoy.”

But gastroenterology experts David Sanders and Matthew Kurien, and Sarah Sleet, Chief Executive of Coeliac UK, argue that removing the prescriptions unfairly discriminates against people with coeliac disease.

Annual prescriptions costs for gluten-free foods were just 0.3 per cent of the total NHS prescribing budget last year.

They argue that “a gluten-free diet is the only treatment for coeliac disease and adhering to this diet is challenging.”

The average cost of gluten-free products are 3-4 times the price of standard equivalent products, and there is limited availability of such products in shops.

Despite this, around 40 per cent of CCGs in England are restricting or removing these prescriptions, while Scotland, Wales, and Northern Ireland are not following suit.

Experts argue that there is no other example in the NHS of a disease having its treatment costs cut by 50 - 100 per cent.

They warn that targeting gluten-free food prescriptions may reduce costs in the short term but there will be long term costs in terms of patient outcomes.